Republican Sens. Jerry Moran of Kansas, pictured, and Mike Lee of Utah are the latest to join Susan Collins of Maine and Rand Paul of Kentucky in their opposition to the latest version of the Senate repeal bill. (John Hanna / The Associated Press)

By THOMAS KAPLANROBERT PEAR

Mon., July 17, 2017

WASHINGTON — Sens. Mike Lee of Utah and Jerry Moran of Kansas declared on Monday night that they would oppose the Senate Republican bill to repeal the Affordable Care Act, killing for now a seven-year-old promise to overturn president Barack Obama’s signature domestic achievement.

The announcement by the senators, both Republicans, left their leaders two votes short of the necessary tally to begin debate on their bill to dismantle the health law. Two other Republican senators, Rand Paul of Kentucky and Susan Collins of Maine, had already said they would not support a procedural step to begin debate.

“There are serious problems with Obamacare, and my goal remains what it has been for a long time: to repeal and replace it,” Moran said in a statement. He added that the Senate repeal bill “failed to repeal the Affordable Care Act or address health care’s rising costs.”

By jumping together, Moran and Lee ensured that no one would be the definitive “no” vote.

With four solid votes against the bill, Republican leaders were faced with two options: go back and try to rewrite the bill in a way that could secure 50 Republican votes, a seeming impossibility at this point, or do as Sen. Mitch McConnell, the Republican leader, had promised and team with Democrats to draft a narrower, bipartisan measure to fix the flaws in the Affordable Care Act that both parties acknowledge.

The Senate Democratic leader, Chuck Schumer of New York, responded to the announcement by urging his Republican colleagues to begin anew and, this time, undertake a bipartisan effort.

“This second failure of Trumpcare is proof positive that the core of this bill is unworkable,” Schumer said. “Rather than repeating the same failed, partisan process yet again, Republicans should start from scratch and work with Democrats on a bill that lowers premiums, provides long-term stability to the markets and improves our health care system.”

The opposition from Paul and Collins was expected, so McConnell had no margin for error as he unveiled the latest version of his bill. He survived through the weekend and until Monday night without losing another of his members — though some expressed misgivings or, at the very least, uncertainty.

McConnell had wanted to move ahead with a vote this week, but was forced to abandon that plan after Sen. John McCain underwent surgery last week. That unexpected setback gave the forces that opposed the bill more time to pressure undecided senators. On Friday, the health insurance lobby, which had been largely silent during the fight, came off the sidelines to blast a key part of the latest Senate bill, saying it was unworkable, would send premiums soaring and would cost millions of Americans their insurance.

McConnell has now failed twice in recent weeks to keep his caucus together for a planned vote. He first wanted to hold a vote in late June, only to postpone it after running into opposition.

Lee, one of the most conservative members of the Senate, had championed a proposal that would allow insurers to sell low-cost, stripped-down plans — an idea that ended up being added to the latest version of McConnell’s bill. But the language added was not quite what Lee had been advocating, his office said after the bill was released.

Moran faced pressure at home about how the bill would affect Kansas, including its rural hospitals. The Kansas Hospital Association said last week that the latest version “comes up short, particularly for our most vulnerable patients.”